Metropolitan Community College Penn Valley

Metropolitan Community College Penn Valley Student Information and Application Packet Radiologic Technology Program

Thank you for your interest in the Radiologic Technology Program. Radiologic Technology The Radiologic Technology program is accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT); 20 N Wacker Drive, Ste 2850, Chicago, IL 60606-3182. Any questions regarding our accreditation status may be addressed by contacting the JRCERT (www.jrcert.org). Graduates of the program are eligible to sit for the national certification examination for radiologic technologists administered by the American Registry of Radiologic Technologists (ARRT). After successful completion of this exam, the individual will be a Registered Radiologic Technologist, RT(R). Most states require licensure in order to practice; however state licenses are often based on ARRT Certification/ registered status. A felony conviction may affect a graduate s ability to sit for the ARRT Certification Examination or attain state licensure. The field of Radiologic Technology is exciting, diverse and rewarding. Physicians rely on the expertise of radiologic technologists to produce diagnostic images of the human body. A variety of work settings are available such as hospitals, outpatient imaging centers, physician s offices, clinics and mobile radiography companies. Individuals who work in radiology may choose from several shift options: daytime, evenings, nights, weekends. We encourage our program graduates to continue their education for enhanced upward mobility within the radiologic science career field. Advanced imaging modalities include: mammography, bone densitometry, computed tomography, magnetic resonance imaging, radiation therapy, nuclear medicine, sonography, interventional radiography including angiography and cardiac catheterization. During your academic experience, you'll be exposed to a very hands-on and interactive learning environment that is both supportive and challenging. Your education also includes clinical experience at varying facilities which will involve direct patient contact and involvement with community professionals. Student should consider this responsibility both an opportunity and a requirement. The Performance Standards, see pages 16-18, should be used to assist each applicant and student to determine if they are otherwise qualified to be a radiologic technologist. It is the policy of MCC Penn Valley to provide reasonable accommodations for individuals with disabilities. If you need an accommodation due to a disability under the Revised 4/2013 2

Americans with Disabilities Act and Section 504 of the Rehabilitation Act, please contact Mirella Jones, Disability Support Services (DSS) Coordinator, 604-4293. Advance notice may be necessary for some accommodations to be provided in a timely manner. Accommodations must be supported by adequate documentation and are determined on an individualized basis. Students should understand that while working in a health care setting, they may be exposed to blood and body fluids, however, the risk should be minimal if standard precautions are observed. This packet includes all the information you will need to apply to the program. After reviewing this information, if you have more questions please e-mail kim.siercks@mcckc.edu. Good luck with your educational pursuit! Revised 4/2013 3

MCC Radiologic Technology Program General Information Program established The radiologic technology program at MCC has been in continual operation since 1969 Program mission statement: The Radiologic Technology Program of Metropolitan Community College- Penn Valley will prepare students for competent entry level service in the healthcare community of diagnostic radiologic technology and create opportunities for graduate success in the profession of radiologic technology. Program philosophy: To be functional members of society and the healthcare community, the individual must demonstrate civic responsibility and self-confidence. The educational program embraces the liberal arts, with comprehensive radiographic instruction and coordinated clinical training. These three disciplines of study comprise the three primary components of the radiologic technology program. These components aid the student in achieving the attributes required by the profession and the community which it serves. Admission and successful completion of the program are determined by clearly defined objectives, regardless of race, color, and creed. National origin or gender. Our ambition is to graduate compassionate individuals who care enough to exercise their minds, giving thought to their daily professional responsibilities, as well as to the world in which they live. The program will remain flexible enough to adjust to the changing needs of the profession and healthcare environment which it serves. Faculty will demonstrate, through their activities, the value of continued education and align the radiologic technology program such that its graduates can successfully matriculate to post graduate programs of radiologic technology. Program goals and learning outcomes: Be workforce ready, demonstrating competence in the entry level skills of the profession o Demonstrate accurate positioning skills o Formulate appropriate technical factors o Practice appropriate radiation protection Communicate effectively and appropriately o Demonstrate effective oral communication o Construct effective written communication Think critically and apply problem solving skills o Adapt radiographic procedure skills to compensate for patient variables o Evaluate radiographic images Exhibit professional growth and seek new knowledge o Prepare and plan continued pursuit of education o Analyze their role in the healthcare team Revised 4/2013 4

Associate Degree in Applied Science (AAS) Accredited by the Joint Review Committee on Education in Radiologic Technology (JRCERT) Graduates eligible to take the National Certification Examination administered by the American Registry of Radiologic Technologists (ARRT) Affiliate program with Johnson County Community College and KCKCC The program is two years in length (24 months) Classes are held M-F, typical hours include 7:30 A.M.-5:00 P.M. Requirements for admitted students Receive a C grade or better in all coursework Students will be assigned to several different clinical facilities throughout the two year program. Some of the clinical facilities are located outside of the KC metro area. Students may be required to travel over sixty miles, one way, for a clinical rotation. Pass the Family care and safety background check (FCSR) Criminal Background Check (CBC): Clinical sites require that only students with an acceptable consumer report, as it relates to criminal background, be allowed to participate in clinical rotations. Therefore, prior to commencing the clinical portion of your program, MCC will have Validity Screening Solutions, a credit reporting agency, conduct a criminal background check. You are responsible for completing the required application information with the credit reporting agency and paying the cost. Criminal background checks are normally conducted once during the program; however, some clinical sites may require a more current report. MCC shall not use the results of a background check as criteria for admission to any program or course. However, you should know that you will not be able to obtain a license to practice or be allowed to participate in clinical should you have an unacceptable background as defined by state law regarding health care providers. An unacceptable background includes a felony and/or class "A" misdemeanor conviction Pass a drug screening Pass a pre-clinical physical examination Obtain an annual TB test Complete the Hepatitis B vaccination series or sign a waiver Submit evidence of MMR, varicella and tetanus vaccinations Purchase Liability Insurance through the college every semester Maintain CPR certification (CPR for the health professional or professional rescuer) Revised 4/2013 5

Answers to Frequently Asked Questions New RATE classes are only accepted once a year to begin the summer semester The program does not utilize a waiting list of applicants All prerequisites must be completed PRIOR to the application deadline of Feb. 15 (no exceptions!) Science and math courses must have been taken within the last five years Completion of all required general education course prior to starting the program would help to lighten the student s semester load but will not shorten the overall length of the program History or the American Institutions requirement must be completed at an accredited Missouri college. This is true for all students, including those attending through JCCC. Students who have completed American History at an institution outside the state of Missouri must enroll in a 1-credit hour course, POLS 153, to meet this requirement. The program does not have an evening or weekend option. The program requires full-time attendance The program is full time with classes and outside requirements occurring during daytime, weekday hours. Note- Students will be required to complete one week of evening shift clinical rotations. Revised 4/2013 6

Steps to Apply 1. The MCC admission application may be completed online at www.mcckc.edu. Select Get Started and follow the steps to apply. 2. Verify eligibility to apply to the program. Eligible applicants have a minimum cumulative GPA of 2.5 and have completed the following prerequisite courses within the last five years with a minimum grade of C : 1. RATE 150: Introduction to Radiologic Technology 2. MATH 110: Intermediate Algebra or higher 3. BIOL 110: Human anatomy 3. If you have previous college courses at an institution other that MCC, submit the transcripts to the MCC Student Data Center, 3200 Broadway, Kansas City, MO 64111. The Student Data Center will determine course equivalencies and post them to your MCC transcript. 4. Complete the program student application form. 5. Transcripts from all external college coursework need to be sent to the RATE program as well as the student data center. Note that it may take a few weeks for transcripts to be sent and received. Therefore, do not wait too long to send transcripts as they may not be received by the Feb. 15 deadline and thus affect your application status. 6. If you have taken courses within the Metropolitan Community College system, you must submit your unofficial/ advising MCC transcript to the radiologic technology program along with your application. 7. Complete the Curriculum Checklist (see page 14). This must be submitted with the program application. 8. Complete two radiology department observations. During the observations, have the technologist complete the observation form and record. Observations must be within the past twelve months of the application deadline. 9. Following each observation, write a two page essay about the experience. 10. Sign the Informed consent statements and submit with your application. 11. Mail or hand deliver the completed application and all required documents to the radiology program director by Feb. 15 Radiologic Technology Program Health Science Institute Metropolitan Community College- Penn Valley 3444 Broadway KCMO 64111-2764 Revised 4/2013 7

Information about your Radiologic Technology application Qualified applicants must: o Possess a high school diploma or GED certificate. o Have a cumulative GPA of at least 2.5 for all college coursework. o Have completed the prerequisite courses DO NOT include any additional materials such as letters of recommendation, cover letters, etc. with your program application. These will not be evaluated and will not positively impact your selection to the program. No applicant files will be reviewed until after the Feb. 15 date. Due to the large number of applicants, confirmation letters/ emails are not sent as applications are received. Applicants with incomplete files will be notified, by email, by the end of February and given two days to submit the missing documents. During the first week of March, qualified applicants will be e-mailed information concerning interviews for program admission. Students will be asked to submit an on-the-spot writing sample during the interview process. (Note- the email will be sent to the email address you list on your program application. It will be sent as a BCC to an applicant distribution group and will be sent from a radiologic technology email account. Make sure your email settings will allow delivery of this type of email. Additionally, if you have not received an email by mid-march, please make sure you check your junk mail and spam folders.) This college does not discriminate on the basis of race, color, national origin, sex, age or disability in admission or access to or treatment of employment in its programs and activities. MCC provides a range of services to allow persons with disabilities to participate in the educational programs and activities. If you desire support services for the application process or coursework, contact Mirella Jones, Disability Support Services (DSS) Coordinator, 604-4293 If you desire academic advising, contact at MCC Penn Valley Advising department at (816) 604-4077 to discuss your needs. JCCC students can contact Melanie Roberts at (913) 469-8500. KCKCC students may contact Dr. Wendel at (913) 288-7126. Applicant selection is based on: o Academic performance, including but not limited to overall college GPA, grades in prerequisite courses, history of repeated coursework and dropped courses, degree attainment and demonstrated ability to handle a full academic load. o Volunteer and work experience related to healthcare o Written and oral communication abilities o Interview responses Revised 4/2013 8

Radiology Department Observations MCC-Penn Valley Radiologic Technology Program As part of the program application process, you are required to perform two, four hour, radiology department observations. 1. You are required to observe in two different facilities; the facilities must also have different ownership. TMC- HH and TMC-LW are both owned by the same entity and would not constitute two different facilities. 2. One observation must be in a hospital radiology department. 3. Both observations may not be in radiology departments of medium to large hospitals; at least one observation must be in a small or rural hospital, an urgent care facility or a freestanding imaging center. 4. You must observe for a minimum of four consecutive hours during each of the observations. 5. Your observation must be between the hours of 7:00am and 5:00pm, on a weekday; Saturday and Sunday observations are not acceptable, evening observations are not acceptable, holiday observations are not acceptable. Most facilities schedule student observations from 8:00-12:00. 6. Your observation must be exclusively in the diagnostic area of radiology. Observations in the special modalities (mammography, CT, MRI, nuclear medicine, ultrasound, and angiography) may not be included in the four hour observation. 7. You must take the observation form and observation record with you and have the technologist complete these forms during your observation. You must submit these forms to the Radiologic Technology Program Coordinator, along with your program application. 8. Following each observation, write a two page essay discussing the observation. This essay must be in APA format and meet college level standards. Attach the essays to the observation forms and submit them with your program application. Revised 4/2013 9

Steps to complete an observation 1. Call the radiology department of your choice and schedule a time when they will allow you to observe the activities of the department. 2. Not all radiology departments allow student observations. The following facilities have notified us that they do not allow student observations. They have requested that students NOT contact them to request an observation. a. Children s Mercy Hospitals b. Lee s Summit Hospital c. Cameron Regional Medical Center d. Overland Park Regional Medical Center e. North Kansas City Hospital f. Diagnostic Imaging Center 3. The following facilities require observers to complete a criminal background check as well as fulfill numerous other requirements. MCC cannot coordinate criminal background checks on students not in one of our allied health programs. Due to this, students should not attempt an observation at these sites. a. Cushing Medical Center - Leavenworth b. Providence Medical Center c. St. John Hospital-Leavenworth d. DDE- V.A. Medical Center 4. The KC-VAMC has requested that students call 816-861-4700 X57502 to schedule an observation. Observations are only scheduled for 8:00-12:00. 5. Proper dress for the observations require you to wear clean dress pants/ slacks, shirt/ blouse, a nametag and enclosed shoes (Your MCC student photo ID card, worn on a lanyard, will serve as your nametag.) Some facilities require observation students to wear a lab coat during their observation; you need to ask the site when you schedule your observation if they require a lab coat. Unacceptable dress includes: crocs, sandals, scrubs, jeans, t-shirts, platform shoes, high heeled shoes, low cut or revealing garments, excessively tight or baggy clothing. 6. If you are unable to make your scheduled observation, you must call the facility to cancel your appointment. 7. If you are late or inappropriately dressed for your observation appointment, you will be sent away and will not be allowed to complete your observation that day. 8. Make sure you bring a note pad and a writing implement to take notes during your observation. Revised 4/2013 10

Metropolitan Community College - Penn Valley Radiologic Technology Program Clinical Facility Observation Form Program applicants are required to observe the practices of the Radiologic technologist, within a medical imaging facility. The individual is to observe the general diagnostic procedures performed within the radiology department. The observation is not to include CT, MRI, mammography, ultrasound, special procedures, nuclear medicine, or radiation therapy. Proper dress for the observations requires the student to wear clean dress pants/ slacks, shirt/ blouse, a nametag and enclosed shoes. Unacceptable dress includes: crocs, sandals, jeans, t-shirts, platform shoes, high heeled shoes, low cut or revealing shirts, skirts, dresses, excessively tight or baggy clothing. Student Name: Date of Observation Name of Observation Facility: Facility contact phone number: Time of Student Arrival: Time of Student Departure: Name and job title of the observation facility personnel who verified the student observation Technologist Signature: Did the student arrive at the scheduled time? Was the student dressed appropriately? Did the student demonstrate proper hygiene practices? Did the student wear the MCC student photo ID card as a nametag? Was the student courteous? Did the student actively participate in the observation? Did the student demonstrate an appropriate interest in the profession? Did the student complete the entire four hour observation, without departing early? List the examinations the student observed: YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO Attention Technologists: If you have questions or comments about this observation, please contact the MCC Radiologic Technology Program Director, Kim Siercks at 816-604-4244 or kim.siercks@mcckc.edu COMMENTS Revised 4/2013 11

Student Name: Observation #1 site: Observation #2 site: MCC- Penn Valley Radiography Applicant Observation Record Place a check mark, in the appropriate column, to indicate each procedure observed. After completion of all observations, each student must have observed a chest x-ray, a portable x-ray, and at least three skeletal exams of different areas of the body. Students are strongly encouraged to observe at least one contrast study. EXAM/ PROCEDURE Observation #1 Observation #2 Routine Contrast Studies Esophagram Video swallow evaluation Upper GI Small bowel series LGI- Barium enema IVU (IVP) Cystogram or VCUG Advanced Contrast Studies ERCP Myelogram Arthrogram Venogram HSG Sialagram Fistulagram Routine and Mobile Exams Chest Abdomen Portable CXR, KUB, or other Skeletal Exams Upper limb: Finger, Hand, Wrist, Forearm, Elbow, Humerus Shoulder: Shoulder, Clavicle, Scapula, AC joints Lower limb: Toe, Calcaneus, Foot, Ankle, Tibia-fibula, Knee, Femur Pelvis: Pelvis, hip Bony thorax: Ribs, Sternum, SC joints Vertebral column: Cervical spine, Thoracic spine, Lumbar spine, Sacrum/ coccyx, SI joints Cranium and facial: Skull, Paranasal sinuses, Facial bones, Nasal bones, Mandible Other exams- please list: Revised 4/2013 12

Metropolitan Community College - Penn Valley Radiologic Technology Curriculum Dept Course # Course Title Credit hours PROGRAM PREREQUISITES COLL 100 First Year Seminar (MCC requires for all students with less than 1 12 credit hours of transcripted college coursework) BIOL 110 Human Anatomy (JCCC: BIOL 140, KCKCC BIOL 141 ) 5 MATH 110 Intermediate Algebra (JCCC 116, KCKCC 104) 3 RATE 150 Introduction To Radiologic Technology 2 TOTAL 11 FIRST SUMMER SEMESTER RATE 160 Fundamentals of Radiologic Technology 2 TOTAL 2 FIRST FALL SEMESTER ENGL 101 Composition & Reading I (JCCC: ENGL 121, KCKCC 101) 3 RATE 165 Patient Care 3 RATE 171 Radiographic Imaging I 3 RATE 172 Radiographic Procedures I 3 RATE 173 Clinical Practice I 3 TOTAL 15 FIRST SPRING SEMESTER BIOL 150 Medical Terminology (JCCC: LC130, KCKCC BIOL 120) 2 SPDR 100 Fundamentals of Speech (JCCC: SPDR 121, KCKCC 151) 3 RATE 174 Radiographic Imaging II 2 RATE 175 Clinical Practice II 4 RATE 176 Radiographic Procedures II 3 RATE 180 Digital Imaging Environment 2 TOTAL 16 SECOND SUMMER SEMESTER RATE 178 Clinical Practice III 4 TOTAL 4 SECOND FALL SEMESTER PSYC 140 General Psychology (JCCC: PSYC 130, KCKCC 101) 3 RATE 270 Radiation Biology and Protection 3 RATE 279 Radiographic Procedures III 2 RATE 280 Clinical Practice IV 5 RATE 285 Imaging Modalities 2 TOTAL 15 SECOND SPRING SEMESTER Completion of American Institutions requirement 3 RATE 278 Radiographic Pathology 2 RATE 281 Radiation Physics 3 RATE 282 Clinical Practice V 5 RATE 283 Final Seminar 2 TOTAL 15 PROGRAM TOTAL 78 Revised 4/2013 13

Metropolitan Community College - Penn Valley Radiologic Technology Curriculum Checklist Student Name MCC Student ID# Cumulative GPA (including ALL college coursework) Dept Course # Course Title Credit Hours PROGRAM PREREQUISITES COLL 100 First Year Seminar (MCC requires for all students with 1 less than 12 credit hours of transcripted college coursework) BIOL 110 Human Anatomy (JCCC: BIOL 140, KCKCC BIOL 141 ) 5 MATH 110 Intermediate Algebra (JCCC 116, KCKCC 104) 3 RATE 150 Introduction To Radiologic Technology 2 FIRST SUMMER SEMESTER RATE 160 Fundamentals of Radiologic Technology 2 FIRST FALL SEMESTER ENGL 101 Composition & Reading I (JCCC: ENGL 121, KCKCC 3 101) RATE 165 Patient Care 3 RATE 171 Radiographic Imaging I 3 RATE 172 Radiographic Procedures I 3 RATE 173 Clinical Practice I 3 FIRST SPRING SEMESTER BIOL 150 Medical Terminology (JCCC: LC130, KCKCC BIOL 120) 2 SPDR 100 Fundamentals of Speech (JCCC: SPDR 121, KCKCC 3 151) RATE 174 Radiographic Imaging II 2 RATE 175 Clinical Practice II 4 RATE 176 Radiographic Procedures II 3 RATE 180 Digital Imaging Environment 2 SECOND SUMMER SEMESTER RATE 178 Clinical Practice III 4 SECOND FALL SEMESTER PSYC 140 General Psychology (JCCC: PSYC 130, KCKCC 101) 3 RATE 270 Radiation Biology and Protection 3 RATE 279 Radiographic Procedures III 2 RATE 280 Clinical Practice IV 5 RATE 285 Imaging Modalities 2 SECOND SPRING SEMESTER American Institutions requirement 3 RATE 278 Radiographic Pathology 2 RATE 281 Radiation Physics 3 RATE 282 Clinical Practice V 5 RATE 283 Final Seminar 2 Date completed Grade Revised 4/2013 14

Approximate Fees and Expenses (Subject to change) Based on a total of 78 credit hours: Tuition In-District Tuition $92.00 per credit hour $ 7,176 Out of District Tuition $161.00 per credit hour $12,558 Out of State Tuition $215.00 per credit hour $16,770 General fee $10/ semester $70 Allied Health fee $20/credit hour $1,100 Lab fees $12/lab hour $ 96 Liability Insurance $35 / semester $175 Dosimetry Fee $20/ semester $120 Books Approximate total $800 Supplies and uniforms Approximate total $300 Family care and safety background check $11 Criminal Background Check $ 56 Total $9,904 Financial Aid and Scholarships are available contact the Financial Aid Office for more information at 816-604-4067. Revised 4/2013 15

Metropolitan Community College Penn Valley Performance Standards Radiologic Technology Performance Standards for Successful Completion of the Radiologic Technology Program These Performance Standards should be used to assist each applicant and student to determine if they are otherwise qualified to be a Radiologic Technologist. It is the policy of MCC Penn Valley to provide reasonable accommodations for individuals with disabilities. If you need an accommodation due to a disability under the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, please contact Mirella Jones, Disability Support Services (DSS) Coordinator, 816-604-4293. Advance notice may be necessary for some accommodations to be provided in a timely manner. Accommodations must be supported by adequate documentation and are determined on an individualized basis. ABILITY STANDARD SOME EXAMPLES OF NECESSARY ACTIVITIES Mobility/ Dexterity Ability sufficient to assist patients to move from room to room and surface to surface, move over varied terrain, and provide safe and effective patient care in a timely fashion. Assist patients with transfers to/from a variety of surfaces and provide proper positioning for the patients independently and safely. Transport adults and children in wheelchairs, on stretchers or on beds. Sensory Ability Fine and gross motor abilities sufficient to provide safe and effective patient care in a timely fashion. Auditory ability sufficient to monitor and assess health needs of patients for safe patient care. Visual ability sufficient for observation and assessment necessary in the operation of equipment and for safe patient care. Manipulate equipment including driving a portable x-ray machine from one location to another Position patients for radiographic examinations Use instruments such as goniometers, tape measures, calipers Manipulate dials, buttons and switches of various sizes Manually move and position radiographic equipment Properly utilize radiographic supplies Detect and respond independently to monitoring alarms, signs of patient s distress and/or a patient s communication of distress Use the telephone to schedule exams, relay exam results and answer questions from other clinicians Respond independently to questions and instructions from other healthcare providers; in close proximity as well as at a Revised 4/2013 16

distance exceeding 20 feet, with and without the presence of extraneous noises Respond to verbal communication from patients and/ or clinicians who may be wearing an oxygen mask or a surgical face mask Detect x-ray collimation light field and radiation field center Perceive and respond independently to warning signals from team members and/or patients of impending danger or emergency, i.e. a change in an individual s appearance, and/or an individual s physical communication of distress. View controls, letters, numbers etc., of varying size, located on radiographic equipment and supplies View radiographic images, on a computer screen, and evaluate for quality acceptance standards Critical Thinking Critical thinking sufficient for safe, clinical judgment. Interpret and carry-out written and verbal communication often in stressful, chaotic situations. Prioritize tasks and make appropriate decisions related to situations. Apply information in classroom to clinical setting, adapting to patients needs. Interpersonal Skill Interpersonal abilities sufficient to interact with patients, families, groups, team members from a variety of social, emotional, cultural, and intellectual backgrounds. Establish rapport and maintain professional boundaries in relationships with patients/families and colleagues. Ability to resolve conflict and to respond to feedback in a professional manner Function effectively under stress Adapt to fluctuating environments (locations, schedules, conditions) Display compassion, professionalism, empathy, integrity, concern for others, interest and motivation Revised 4/2013 17

Communication Communication abilities sufficient for interaction with others orally and in writing Comprehend instructions and written documentation Instruct patient/ family Document exam information Communicate with radiographers and radiologists. Professional Behavior Behavior consistent with the standards and core values of the profession. Regular prompt attendance Ability to self-assess and implement self-improvement strategies Demonstrate appropriate levels of dress and grooming including that required in controlled and sterile environments Ability to self-regulate emotional responses Ability to maintain composure during stressful or chaotic situations Properly wear personal protective items appropriate to the situation Revised 4/2013 18

Allied Health and Nursing Programs Immunization/Titer Requirements The immunization/titer requirements given below are recommended for health care workers by the Centers for Disease Control (CDC). In addition, each Allied Health and Nursing Program is required by clinical contract to submit documentation, which includes immunization/titer results, on all students upon request. It is the College s policy that all of the following immunization/titer requirements be complete before any student can participate in a clinical experience. TITER / IMMUNIZATION REQUIREMENTS Hepatitis B The Hepatitis B vaccine Official Documentation must be provided for all three injections and a titer drawn showing proof of immunity. OR A signed Hepatitis B waiver must be on file in the Program Clinical Coordinator s office or other designated office. Note: signing the waiver releases you from having a titer drawn if you have had the 3 injections. It is the choice of the student whether he/she wants information regarding immunity. Chickenpox (varicella) Complete an IGG titer. Titer must be dated and the result showing evidence of immunity must be a part of the Official Documentation. (Equivocal or Negative is not acceptable.) If no immunity is present, two immunizations must be taken. OR Have two immunizations completed and take official documentation to Program Clinical Coordinator or other designated office. Measles, Mumps, Rubella Complete an IGG titer for each (measles, mumps, rubella). Titers must be dated and the result showing evidence of immunity for each (measles, mumps, rubella) must be a part of the Official Documentation. (Equivocal or Negative is not acceptable.) If no immunity is present, two immunizations must be taken. OR Have two immunizations completed and take Official Documentation to Program Clinical Coordinator or other designated office. Tuberculosis Screen Must have official documentation of a current annual skin test (cannot be over one year old). If you have an expired TB skin test or never had a TB skin test, then the 2 step Mantoux skin test is required (two recent screenings 1 week apart). Results must be documented in millimeters of tissue involvement (induration). A Quantiferon blood test with negative results is also acceptable. If TB test is positive or the student has history of positive skin tests, a Negative Chest X- Ray (less than 2 years old) is required. If the student submits a negative chest x-ray, they will be required to complete an annual TB symptom assessment while in the program. Revised 4/2013 19

Tetanus-Diphtheria The initial series is typically given in childhood and boosters are required every ten years. The booster should be of Tetanus-Diphtheria and acellular pertussis (TDaP). If the booster has been given within the last ten years, provide official documentation of the date (month/day/year) of the immunization. If the booster is ten years old or older, have the TDaP immunization and provide official documentation of the date (month/day/year) of the immunization. Titers are not acceptable for any portion of TDaP. Official Documentation (lab results) for each titer must be provided. Immunization dates (mm/dd/yyyy) must be included in an official document stating the student s name, date of immunization, and name of immunization. An Official Document must show the health care provider s name/organization, and phone number and have appropriate signatures, for example a physician s prescription pad, an official clinical record. TB testing results must show the student s name, health care provider s name/organization, date placed, date read, results in millimeters induration, and have appropriate signatures. Revised 4/2013 20

A Summary of Your Rights under the Fair Credit Reporting Act Metropolitan Community College Criminal Background Checks (CBCs) for Allied Health, Nursing and Continuing Education Programs Clinical sites require that only students with an acceptable consumer report, as it relates to criminal background, be allowed to participate in clinical rotations. Therefore, prior to commencing the clinical portion of your program, Metropolitan Community College (MCC) will have Validity Screening Solutions, a credit reporting agency, conduct a background check. You are responsible for completing the required application information with the credit reporting agency and paying the cost. Criminal background checks are normally conducted once during the program; however, some clinical sites may require a more current report. MCC shall not use the results of a background check as criteria for admission to any program or course. However, you should know that you will not be able to obtain a license to practice or be allowed to participate in clinical should you have an unacceptable background as defined by state law regarding health care providers. An unacceptable background includes a felony and/or class "A" misdemeanor conviction. Revised 4/2013 21

Metropolitan Community College Criminal Background Checks (CBCs) and Family Care Safety Registry (FCSR Allied Health, Nursing and Continuing Education Programs Criminal Background Check (CBC) and Family Care Safety Registry (FCSR): Clinical sites require that only students with an acceptable consumer report, as it relates to criminal background, be allowed to participate in clinical rotations. Therefore, prior to commencing the clinical portion of your program, Metropolitan Community College (MCC) will have Validity Screening Solutions, a consumer reporting agency, conduct a background check. You are responsible for completing the online application and paying the cost. Criminal background checks are normally conducted once during duration of the program; however, some clinical sites may require a more current report. You will be responsible for applying online and paying for the cost of the additional background check if it is required by the clinical site. The cost of each background check is $51.00 plus a $1-$2 processing fee depending upon your method of payment. In addition, The Department of Mental Health (DMH) has implemented a requirement that impacts Allied Health and Nursing students. This new guideline requires that all persons who come in contact with consumers in a Missouri mental health setting must have a Family Care Safety Registry (FCSR) background screening. The FCSR is a background screening that is not included in the standard Validity Screening Solutions Criminal Background Check. You are responsible for completing the required application information with the Missouri Department of Health and Senior Services and paying the cost. As with the CBC, the FCSR is normally conducted once during the program; however, some clinical sites and extending your program length may require a more current report. You will be responsible for applying online at the FCSR on the Missouri Department of Health and Senior Services website and paying for the cost of $10.00 for being placed on the registry plus $1.00 for processing online. Any addition report required by either a clinical site or MCC will be at no additional cost to you once you are on the registry. Finally, an Employment Disqualified List (EDL) check is required of students whose programs are exempt from the FCSR. Your Clinical Coordinator will let you know if you are in a program that is exempt from the FCSR. There is no cost for this check. Your Clinical Coordinator will complete an EDL Form for each class of students. The completed EDL Form is faxed to the Missouri Department of Health and Senior Services. The results are sent to the program s Clinical Coordinator. No MCC employee will send this information directly to a clinical site. You will be responsible and must provide the information to the clinical site. You should know that you will not be able to obtain a license to practice or be allowed to participate in clinical should you have an unacceptable background as defined by state law regarding health care providers. An unacceptable criminal background includes a Revised 4/2013 22

class A, B, and some C felony and/or some class A misdemeanor conviction for a crime against person. Findings reported by the FCSR which include substantiated child abuse/neglect findings, open criminal records, placement on the Department of Health and Senior Services Employee Disqualification List (EDL), placement on the Department of Mental Health s Employee Disqualification Registry, or denial/revocation/suspension of a foster parent license may also result in your inability to obtain a license to practice or be allowed to participate in clinical defined by state law regarding health care providers. MCC realizes that the background checks ordered by you at the onset of your program are a report of your history only inclusive to the date of your online application and payment for this background check. Should you be convicted of an offense that falls within unacceptable background as defined by state law regarding health care providers after you have completed the background check and while you are still in the program, it is strongly recommended that you reveal your current status to the Compliance Coordinator. Your status has changed and your ability to obtain a license and practice and to continue your clinical experiences has been severely compromised. Ordering Options are provided on the attached forms as step-by-step directions on how to complete each background screening online. MAKE sure you read the directions from Validity Screening Solutions and for the Family Care Safety Registry fully because a mistake in completing the online information will delay the completion of the CBC and/or the FCSR, which will delay your ability to participate in the clinical rotation. The results of your consumer report will be sent to the Compliance Coordinator via an electronically secure file from Validity. Compliance Coordinator will send a current CBC Results list of students to your Program or Clinical Coordinator which indicates only an ACCEPTABLE Pass (P) or INCOMPLETE (I ) status by each student s name. You will provide a copy of your FCSR to your Program or Clinical Coordinator who will give your sealed report to the Compliance Coordinator. The Compliance Coordinator will send a current FCSR Results list of students to your Program or Clinical Coordinator which indicates the date you passed the screening as indicated on the report you provided. If your report is older than 6 months old, you will have provisional pass; you will need a new report before you will be allowed to be placed in a clinical situation. If you an UNACCEPTABLE criminal background report or FCSR screening, the Compliance Coordinator will direct you on how to proceed. As noted in the Summary of Your Rights Under the Fair Credit Reporting Act, you have the right to request and receive a copy of your consumer report from Validity Screening Solutions. An individual with a certain type of finding identified in their FCSR screening has the right to apply for a Good Cause Waiver (GCW) through the Missouri Department of Health and Senior Services. If granted, the GCW would not correct or remove the finding, but would allow you to participate in a clinical placement and to be employed on a conditional basis. Revised 4/2013 23

The turnaround time for the CBC is approximately 48-72 hours, if paid by credit card or PayPal. It can take longer for the CBC to be processed (sometimes more than 2 weeks) if paid by money order /cashier s check. The turnaround time for the FCSR is approximately 1-2 weeks if paid for online. However, the department may have backlog of reports to do and the turnaround time can be as long as 6 weeks. Plan accordingly in order to have the CBC and FCSR completed so you are ready to start your clinical rotation on time. NOTE: The Compliance Coordinator will not keep a copy of the either the Validity Criminal Background Check or the Family Care Safety Registry for the student to have if a facility requires that this documentation be presented before a student can commence a clinical placement there. The student must be able to present this documentation to the clinical site (along with any other requested CNE requirement). Therefore, it is imperative that each student gets, makes and keeps a copy of both the CBC and the FCSR results for his/her own files. Revised 4/2013 24

CRIMINAL BACKGROUND CHECK INSTRUCTIONS On January 1, 2004, the Joint Commission instituted new regulations that must be followed in order for hospitals, home health agencies, clinics, etc., to gain or maintain accreditation status. One of these new regulations requires all persons who are involved in-patient care activities, i.e., employees, volunteers and students must have criminal background checks as well as other healthcare related checks. In order for you to be placed in a clinical site you must complete a background check with Validity Screening Solutions. Here is what you need to do: 1. Go to the secure link below: https://www.validityacademics.com 2. Enter the Username and Password below: Username: mcc8654 Password: background 1. Select your Department: RADIOLOGIC TECHNOLOGIST 2. Select your Program: FULL BACKGROUND CHECK 3. Create a personal profile by completing the required fields 1. If your email has been used in a previously created profile you will need to log in via the Returning Student Log-In section, select the New Screening Profile link on the next page and select RADIOLOGIC TECHNOLOGIST again, followed by FULL BACKGROUND CHECK. 2. If you have forgotten your password you can click on the password (forget?) link and answer the security question you chose when you first creating your personal profile. 4. Complete each section of the screening profile 1. Enter at least one employer in the Employment section 2. Review the screening profile to ensure all sections are complete and click Next 3. Read the Notice and Disclosure and check the confirmation box 4. Read the Summary of Rights under the Fair Credit Reporting Act and check the confirmation box. 5. Fill out all form fields in the Certification and Release and enter your signature in the electronic signature box. 6. Choose a payment option: 1. Credit Card (Visa or MasterCard) $51.00 plus $1.00 administrative fee 2. PayPal $51.00 plus $2.00 administrative fee 3. Money Order or Cashier s Check $51.00 7. Select Submit Results will be forwarded to Metropolitan Community College. Instructions on how to access your completed report via your profile page will also be sent via email once your profile has been submitted. If you have any questions please feel free to contact Dawn Sharp at (816) 604-4815 or dawn.sharp@mcckc.edu. You may also contact Validity Screening Solutions with technical questions at 913.322.5995, toll-free at 866.920.5995 or via email at students@validityscreening.com. NOTE: Compliance Coordinator will not keep a copy of the Validity Screening report. You must be able to present this documentation to the clinical site (along with any other requested CNE requirement) upon their request. Therefore, it is imperative to get and keep a copy of the Criminal Background Check Report from Validity for you own files. Revised 4/2013 25

FAMILY CARE SAFETY REGISTRY INSTRUCTIONS The Department of Mental Health (DMH) has implemented a requirement that impacts Allied Health and Nursing students. This new guideline requires that all persons who come in contact with consumers in a Missouri mental health setting must have a Family Care Safety Registry (FCSR) background screening. The FCSR is a background screening that is not included in the standard Validity Screening Solutions Criminal Background Check. In order for you to be placed in a clinical site, you must complete a background check with the Family Care Safety Registry Here is what you need to do Part 1: 1. Go to the Family Care Safety Registry web site at http://www.dhss.mo.gov/fcsr. 2. Click on how to register and follow the directions: a. Enter Social Security Number b. Enter type of worker Voluntary c. Enter Name and Date of Birth d. Enter mailing address e. Agree to the statement f. Enter a payment information: Cost of this screening is $10.00 if done by mail or $11.00 if done on-line (requires a valid credit card). Please note that it could take up to 2 weeks to be placed on the registry if using the mail option; only 24-48 hours if application and payment is done online with a credit card. 3. Within a couple of days, you will receive a mailing verifying that you are registered. If you only receive verification of payment, at this point proceed to Part 2, Step 1. 4. The verification might also include your background screening findings. The letter will state no findings reported in the background screening or may report some type of finding. If this is what you receive, proceed to Part 2, Step 3. 5. If you are already on the registry and have a findings letter, proceed to Part 2, Step 3. However, if the results letter that you have is more than 6 months old, proceed to Part 2, Step 1 to request a more recent screening. This will not cost you anything as your registration fee has already been paid and is valid. Here is what you need to do Part 2: 1. Go to the Family Care Safety Registry web site at http://www.dhss.mo.gov/fcsr 2. Follow the instructions for requesting a background check: a. Call 1-866-422-6872, between 7:00 a.m. and 5:00 p.m., Monday through Friday. b. Provide your name and address as well as your social security number. c. You should receive written confirmation of your background screening results usually within 2 weeks. 3. Once you have received the written confirmation of your results, make a copy of the results. Keep the original letter for your files. NOTE: Compliance Coordinator will not keep a copy of the FCSR. You must be able to present this documentation to the clinical site (along with any other requested CNE requirement) upon their request. Therefore, it is imperative that you make a copy and keep a copy of the FCSR results for your own files. 4. Bring the copy of this background screening letter in a sealed envelope that has your name and program written on it to your Program Coordinator. Your Program Coordinator will give these sealed envelopes to the Healthcare Career Coordinator who will then use this information to verify each student s passing the registry. Any student failing to submit this requirement will not be allowed to attend a clinical. If you have any questions please feel free to contact the MCC PV Compliance Coordinator at 816-604-4815 or dawn.sharp@mcckc.edu. Revised 4/2013 26

Drug-Free Workplace, Campus and Community Drug Screen Policy MCC Penn Valley (the College ) is committed to maintaining high standards in all programs, including its Allied Health and Nursing Education and Practice programs. Safe practice requires efficient, reliable, and unimpaired student performance at all times, including in the classroom and in clinical settings. Students are required to perform all education related activities in appropriate mental and physical condition. Being under the influence of illegal drugs or alcohol is not only in violation of MCC s Student Conduct Code, but it also poses serious safety and health risks to the user and to all persons who come in contact with him/her. As discussed below, clinical affiliation sites may require students to complete drug screening before they will be placed in the clinical setting, and some clinical sites may also require drug screening, with or without cause, during the course of the clinical placement. As provided below, you may also be asked to complete a drug test according to individual program requirements and/or MCC policy. MCC-PV has adopted the Federal Drug-Free Workplace Act of 1988 and Drug-Free Schools and Communities Act Amendments of 1989. The policy is one of zero tolerance. The Code of Student Conduct imposes disciplinary sanctions for the use, possession, or distribution of alcoholic beverages and the illegal use, possession or distribution of drugs and controlled substances on MCC premises or at any MCC sponsored activity. A positive drug test may be cause for dismissal from an Allied Health or Nursing program as well as from the College. Additionally, a positive drug test may cause you to be excluded from all clinical sites and may also preclude you from taking state licensure examinations. MCC Testing Criteria, Cost and Sanctions Any Allied Health or Nursing student who demonstrates behavioral changes suspected to be related to the use of drugs, including but not limited to alcohol, will be required to submit to drug testing. While the Dean s decision to refer a student for drug testing shall be reasonable under all the circumstances, things upon which the Dean may base his/her determination to require drug testing may include, but are not limited to: Observable phenomena such as direct observation of drug use and/or physical symptoms or manifestations suggesting that the student is under the influence of a drug and/or alcohol. Erratic behavior, slurred speech, staggered gait, flushed face, dilated/pinpoint pupils, wide mood swings, and deterioration of work. Information that a student has caused or contributed to an accident, or near accident, that resulted in personal injury, including death, to a patient/client, fellow student, MCC or clinical site employee or any other person. The student s conviction, being judged guilty of or pleading nolo contendere to a drug, alcohol or controlled substance infraction in a federal or Missouri state Revised 4/2013 27

court, including municipal and magistrate courts, or in a court of any other state having appropriate jurisdiction. Any Allied Health or Nursing student who is referred for testing shall be responsible for the costs of such testing. Any student who tests positive for alcohol and/or unlawful drugs or controlled substances for which he/she cannot produce a valid and current prescription is subject to removal from his/her clinical rotation, resulting in his/her inability to complete the program requirements and the consequent removal from the program. In order to uphold the importance of due process, the student in question shall have the right to a full and fair hearing, including the right to present witnesses and evidence on her/his behalf, before the imposition of any such internal program sanction. Of utmost importance is the well-being of patients (if involved). In addition to program sanctions, the student may be suspended or expelled from the College for violation of the Student Conduct Code. Clinical Site Testing, Sanctions and Cost As noted above, in addition to MCC-PV testing and potential sanctions, clinical sites impose their own requirements for drug and alcohol testing. Clinical facilities are, like MCC-PV, committed to providing a safe environment in order to protect their patients, residents, employees and visitors; to provide the highest level of service; and to minimize the potential for accidents and injuries. Therefore, many of the clinical contracts between MCC PV and the hospitals, clinics, and other clinical sites and facilities at which MCC-PV places its students for clinical rotations mandate that MCC PV allied health and/or nursing students complete and pass a drug screen prior to being admitted into the facility for clinical rotations. Other clinical sites require random drug and/or alcohol screening for allied health and/or nursing students. Apart from a student s internal due process rights, which, as noted above, address the rights of the student vis-à-vis MCC-PV sanctions, the refusal of a student to submit to a clinical site s initial drug screen or to random testing may result in the student s inability to do or to conclude clinical training at the clinical site. Likewise, a positive test may result in the student s immediate removal from the clinical site. The cost for a drug screen may be covered by the clinical facility. If not, the student is responsible for the cost. Revised 4/2013 28

Metropolitan Community College - Penn Valley Radiologic Technology Program Informed Consent Printed Name Date Student Information Packet I have read the Student Information Packet. Signature Use of Application and Transcript Information I understand that information provided in the program application and college transcripts will be utilized for purposes of determining eligibility to the program and for academic advising and counseling by program faculty. Information contained within the application will be provided to academic counselors/advisers for purposes of advisement and counseling. Data regarding student demographics is reported to MCC administration and the program accrediting body in aggregate and without student identifiers. All other uses of student information would require the written permission of the student. I understand and give permission for use of student information as outlined above. Signature Program Communication Regarding Interviews I understand that all communication from the program regarding the admission process will be sent to the email address that I provide on the program application for admission. I further understand that if I do not attend the interview sessions at the designated time, for any reason, I will no longer be considered for program admission. I understand that no exceptions will be made to this policy. Signature Program Admission I understand that the program capacity is limited and therefore, the application process is competitive. As such, if the number of applicants exceeds the number of positions in the program, the best qualified applicants will be determined based on: Academic performance, including but not limited to: GPA, grades in prerequisite courses, history of repeated coursework and dropped courses, degree attainment, and demonstrated ability to handle a full academic load Volunteer or work experience related to health care Written documentation Oral communication Interview performance Signature Revised 4/2013 29

DATE: Metropolitan Community College - Penn Valley RADIOLOGIC TECHNOLOGY PROGRAM 2014 STUDENT APPLICATION (MS/MR) Last First Middle Name(s) that appear on previous educational records if different from above Last First Middle Mailing Address Number Street City State Zip Phone number E-Mail address Note- all correspondence from the program will be sent to this email address MCC Student ID Number In case of emergency notify High School: Dates attended and date of graduation (or date of GED) Colleges Attended Beginning with most recent, list all colleges you have attended. Request that official transcripts be sent to: Radiologic Technology Program Health Science Institute Metropolitan Community College- Penn Valley 3444 Broadway KCMO 64111-2764 College City/State Dates Attended Degree Revised 4/2013 30

Work Experience Employer Job Title Dates of Employment Volunteer Experience Note any volunteer experience you have in radiography. Identify the facility and contact person as well as the dates of the experience and hours per week. List any other volunteer experience outside of radiologic technology as well. Note- Radiology department observations do not count as volunteer experience. Revised 4/2013 31